High school football saving brains as game goes on

A Mira Mesa junior varsity high school football player is attended to by training staff after being hit by an Oceanside Pirates player during their game in Oceanside, California September 14, 2012.
(Mike Blake, Reuters)

(Reuters) - In the small northeast Ohio town of Massillon, a few miles from the National Football Hall of Fame, some 20,000 fans pack into a high school stadium, drowning out the roar of a real tiger mascot on the sidelines.

Football is akin to religion in Massillon and, like a religion, it can be resistant to change. For decades jolts to the head were written off as "getting your bell rung" and considered part of the game. Now, concerns about serious brain injuries have penetrated American football culture and high schools are taking action.

After an off-season with suicides by two former National Football League players, publicity over a lawsuit against the league by NFL players and new studies adding to the growing body of research, nearly every state entered the fall season with some type of legislation protecting young athletes.

Jamey Palma, the assistant principal of Washington High School in Massillon, knows the pressure players feel to play through concussions. A high school and college player, he said he suffered four concussions, including one during a game in high school when he stayed in until the end.

The concussion was discovered afterward, when he failed to remember what happened on the field.

"Back in those days, we'd play through it," said Palma, 36.

Now many coaches and players know "seeing stars" might very well be a concussion and a concussion is a brain injury that needs time to heal.

The Ohio High School Athletic Association has devised rules to immediately remove a player and provide him medical attention upon showing signs of a concussion, said Hank Zaborniak, the association's assistant commissioner.

Between 2009 and 2011, 33 states plus the District of Columbia passed laws aimed at preventing concussions in youth sports, and another 15 states have introduced legislation this year, according to the National Conference of State Legislatures. Only Montana and Arkansas have yet to act.

Many were inspired by the case of Zackery Lystedt, who suffered a life-threatening brain injury and permanent disability when at age 13 in 2006 he was sent back into the second half of a game after suffering a concussion.

With Zackery recovering enough to tell his story, a Washington state coalition of medical professionals, later backed by the NFL and the American College of Sports Medicine, helped pass "Lystedt Laws," first in Washington and then around the country.

"This is a brave young man who put a face on traumatic brain injury," said Dr. Stanley Herring of the University of Washington School of Medicine and a Lystedt Law advocate.

IMPROVED RULES, EQUIPMENT

In the meantime, experts explore improvements in helmet design and advanced mouth guards. Some coaches mandate neck strengthening as prevention. Since 2010, the National Federation of State High Schools rule book requires removing a player from a game when he shows signs of a concussion.

With rule changes and better equipment, death has become increasingly rare. Of 1.1 million high school football players, two died of brain injury in 2011, when a rate of 0.86 per 100,000 players suffered permanent brain damage, according to an annual study by a University of North Carolina researcher.

A 2011 study by researchers from the Perelman School of Medicine at the University of Pennsylvania found that survivors of a single traumatic brain injury in young adults can show changes in their brains years later, possibly leading to neurodegenerative disease similar to Alzheimer's.

In Ohio, where 715 high schools play football, the rules removed 102 high school football players from games last year. Thirteen of them returned to the game after being checked out by medical professionals but most were held out for the remainder of the game and many for several games.

The Ohio House has passed a bill that would require youth sports coaches and officials to do what Zaborniak's group now requires in high schools - remove a player from a game or practice if the player is exhibiting symptoms or behavior consistent with concussions. The Ohio Senate has yet to approve the legislation.

Alabama is developing a concussion data bank. A California law approved in August requires trainers to understand the signs and symptoms of concussions and know the appropriate responses. Texas, with a reputation as football-mad state, established a protocol for player safety that athletic directors say is among the most stringent in the country.